| NPI | 1710796560 |
|---|---|
| Former Name | ASHLEY ELIZABETH VAN DYKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-70483) |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |